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(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Intermediate Care Facility, Mentally Retarded |
315P00000X |
| NPI # | 1194901751 |
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| LBN Legal business name | HENRY HAGEN RESIDENCE | ||||
| Authorized official | ROGER REYNOLDS - (OWNER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 01/14/2008 | ||||
| Last updated | 01/14/2008 - About 18 years ago | ||||
| Identifiers |
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HENRY HAGEN RESIDENCE
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HENRY HAGEN RESIDENCE